Image Archiving for Digital Pathology

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Image Archiving for Digital Pathology

Which Way to Turn?

Glenn Taylor,

MD, FRCPC, FACP

Head, Division of Pathology, Hospital for Sick Children Associate Professor, University of Toronto

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Disclaimers

• User

• Apollo PathPACS

I have no financial interest with Apollo or any other

commercial enterprise mentioned in this

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Image Archiving for Digital Pathology

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Hospital for Sick Children

Toronto, Ontario

Largest pediatric hospital in Canada

Provincial, national and international patients Canada’s largest hospital-based child health research institute

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Division of Pathology

Clinical, Research and Referral

• Surgical and autopsy pathology

– Coroner’s pediatric autopsies

• Immunohistochemistry • Electron microscopy

– Provider arrangements

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Division of Pathology

– Coroner’s pediatric cases

• Immunohistochemistry • Electron microscopy – Provider arrangements • Molecular pathology Pathology Users • 10 pathologists • 2 fellows, up to 6 residents • 3 research scientists • 3 pathologists assistants • 5 EM technologists • 3 immunohistochemistry technologists • 1 morphometry technologist • 1 imaging consultant

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Hard Copy Image Archive

Images lost, misfiled or “borrowed” Physical vulnerability of slides and prints

No built in backup system Limited security options Outside of institution processing

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Digital Image Archive

Limitations

• File format support

• Image acquisition

• Hospital IS interface

• Hospital IS support

• Application lifespan

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Division of Pathology

– Coroner’s pediatric cases

• Immunohistochemistry • Electron microscopy

– Provider arrangements

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Division of Pathology

• Macroscopic specimens • Photomicroscopy

• Electronmicrographs • Digital Faxitron images • Document images

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Digital Image Archive Requirements

• Reliable

• Secure

• Useable

• Flexible

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Digital Image Archive Requirements

• Reliable

• Secure

• Useable

• Flexible

• Obsolescence Resistant

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Digital Image Archive Requirements

• Legislation

• Hospital

• Division

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Legislative Requirements

• Provincial Legislation (Ontario)

– Personal Health Information Protection Act

– Freedom of Information and Protection of Privacy

Act

– Coroner’s Act

• Hospital Bylaws and Regulations

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Hospital Requirements

• Mission

_{• Goals and objectives}

– Clinical, research and

education

• Hospital IS interface

• Hospital IS hardware

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Hospital Requirements

• Mission

• Affordable

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Hospital Requirements

• Mission

• Affordable

• Reliable

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Hospital Requirements

• Mission

• Affordable

• Reliable

– Vendor

• Proven track record with

installed user base

• Partnerships with other

vendors

• Solid hardware and

software background

• Financially sound

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Hospital Requirements

• Mission

• Affordable

• Reliable

– Vendor – Hospital IS

• Standard image file

formats

• ODBC and other

standards compliant

• IS infrastructure

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Division of Pathology Requirements

Reliable

Secure

Useable

Flexible

• Clinical

– Acquisition of images from all AP lab sections – Pediatric forensic

autopsy image security

• Research

• Teaching

• Administration

• Users

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Division of Pathology Requirements

Reliable

Secure

Useable

Flexible

• Clinical

– Acquisition of images from all AP lab sections

– Pediatric forensic

• Research

• Teaching

• Administration

• Users

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Image Archive Security

Permissions

Audit Trails

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Image Archive Security

Permissions set on:

– Archive type – User role – Case type – Specimen type – Image class – Image

Administrator

Viewer

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User Log-on Accessioning Sets User Role Sets Specimen Class Sets Image Type Security Permissions

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User Functions

• View

• Annotate

• Modify*

• Create

• Print

• Import

• Export

• Restrict

• Inactivate

• Functions individually

allowed or prohibited

• Functions audited

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Division of Pathology Requirements

Reliable

Secure

Useable

Flexible

• Clinical

– Acquisition of images from all AP lab sections – Pediatric forensic

• Research

• Teaching

• Administration

• Users

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Division of Pathology Requirements

Reliable

Secure

Useable

Flexible

• Division

• Department

• Hospital

• External clients

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Useable

and Flexible

Division Services

• Clinical

– Case documentation – Case analysis (EM,

morphometry)

– Case presentation (clinical rounds)

• Academic

– Research – Teaching

– Conferences and Publications

• Administration

– Quality assurance

Division Operations

Integration within laboratory work flow

adapting work flow to fit image archive

versus

customizing image archive to fit work flow

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Useable

and Flexible

Division Operations

Integration within laboratory work flow

adapting work flow to fit image archive

versus

customizing image archive to fit work flow

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Useable

and Flexible

Simple Data Entry

• Simple metadata entry without redundancy

• Interface with Pathology LIS

– Flexible entry options

– “Down-time” contingencies

• Automatic security permissions

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Useable

and Flexible

Pathology Users • 10 pathologists • 2 fellows, up to 6 residents • 3 research scientists • 3 pathologists assistants • 5 EM technologists • 3 immunohistochemistry technologists • 1 morphometry technologist • 1 imaging consultant

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Useable

and Flexible

Pathology Users • 10 pathologists • 2 fellows, up to 6 residents • 3 research scientists • 3 pathologists assistants • 5 EM technologists • 3 immunohistochemistry technologists • 1 morphometry technologist • 1 imaging consultant

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Flexible

• Scalable

• Adaptable

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Flexible

• Scalable

• Adaptable

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Image Output

• Within Division

– Viewing – Exporting – Printing

• Outside Division

– Viewing • Other permissions – Clinical Rounds – Consultation

• Static images

• Audio-video streams

• Virtual microscopy

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Pathology Digital Archive Division of Pathology Clinical Services Researchers Teaching and Rounds Pathologists Within Hospital

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Within Hospital Pathology Digital Archive Division of Pathology Clinical Services Researchers Teaching and Rounds Pathologists

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Outside Hospital Within Hospital Pathology Digital Archive Division of Pathology Clients Consultants Teaching and Rounds Distance Pathologists Clinical Services Researchers Teaching and Rounds Pathologists

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Flexible

• Scalable

• Adaptable

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Flexible

• Scalable

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Image Archiving for Digital Pathology

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Pathology Digital Image Archive

• Reliable

• Secure

• Useable

• Flexible

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Clinical Digital Image Archive

• Reliable

• Secure

• Useable

• Flexible

• Dermatology

• Gastroenterology

• Ophthalmology

• Plastic Surgery

• Pediatrics

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Thanks To

Sick Kids Implementation Team

Daniela Crivianu-Gaita

VP IS

Michael Anderson

Team Leader DPLM IS

Lois Child

Lab IS Resource Technologist

Rita Pyle

Project Manager IS

Michael Starr

Image Consultant

Don Perrin

PhD PA (ASCP)

Jim Choi

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Thanks To

Apollo PathPACS

Mark Newburger

Tom Campbell

Jeff Mabus

John Reichert

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Image Archiving for Digital Pathology

Which Way to Turn?

Glenn Taylor,

MD, FRCPC, FACP

Head, Division of Pathology, Hospital for Sick Children Associate Professor, University of Toronto